Last Updated on February 28, 2024 by Partha Protim Choudhury
As women, it is important to recognize that conditions like uterine cancer can have a significant impact on our lives. Knowing about uterine cancer is crucial for increasing awareness, promoting early detection and empowering all of us to make informed decisions about our health. Please keep in mind that this awareness empowers all of us with the necessary tools to proactively take measures, cultivating a culture, prevention and enhancing the overall quality of our lives.
Dr Viral Patel is a distinguished gynaecological oncologist and robotic surgeon based at SCG Hospital in Ahmedabad, Gujarat. Dr Viral holds the distinction of being the first gynaecological oncologist and robotic surgeon in Gujarat. With surgical experience spanning over ten years and performed many gynaecological cancer surgeries, Dr Patel has expertise in all surgical and non-surgical gynaecological procedures along with robotic and laparoscopic surgeries and advanced cytoreductive surgery including HIPEC and PIPEC gynaecological procedures.
What is uterine cancer and why is it believed to be the gynaecological cancer that affects women most frequently in affluent nations?
Dr Viral Patel: Okay. Yeah. First of all, I just want to clarify one thing. Yeah, cancer is a little horrible for all of us. But the thing is not to worry about that. It is treatable if we are aware and can detect it in the early stage. So, there is no need to worry about cancer. And now coming to your question, yes, uterine cancer is a gynaecologic cancer. In gynaecologic cancer, there are generally four main cancers: uterine, ovarian, cervical, vulval, and vaginal cancer.
Uterine cancer is more prevalent in developed countries. However, in India, there is a significant socio-economic class distribution. Some experience high-income growth, while others face poor socio-economic growth and low income. Interestingly, the incidence of uterine cancer is similar in both well-to-do, high-income families and affluent nations.
What are the different forms of uterine cancer?
Dr Viral Patel: Generally, uterine cancer has two main types: carcinoma and sarcoma. Both have similar treatments, but some modalities may vary. In essence, uterine cancer is a malignancy affecting the uterus and its inner lining, known as the endometrium. If the cancer originates in the inner muscle of the uterus instead of the lining, it is termed sarcoma.
What are the primary causes of uterine cancer? Also, please explain its non-hormonal and non-genetic risk factors.
Dr Viral Patel: It’s a very important and good question. Generally, when the uterus is exposed to higher-than-normal levels of estrogen over several years, it leads to specific changes in the inner lining of the uterus, increasing the risk of cancer. In cases where females experience early menstruation or women undergo menopause at a later stage, typically around the age of 50-55 years, the exposure to estrogen may be elevated. However, there can be other contributing factors, such as PCOS, which can also heighten estrogen exposure. Over time, this heightened exposure may elevate the risk of uterine cancer.
What symptoms or clinical indicators should women be aware of?
Dr Viral Patel: This is crucial for people to grasp. Typically, Indian women experience menopause between the ages of 45-50. Blood spotting after menopause can be a symptom of uterine cancer. While not everyone with spotting has uterine cancer, it’s essential to consult a doctor in such cases for confirmation. Spotting can be easily overlooked, so I recommend patients wear light-coloured undergarments, particularly after menopause, to promptly detect any spotting.
How is uterine cancer diagnosed, and why is early screening crucial for detection?
Dr Viral Patel: Typically, when a woman experiences post-menopausal bleeding or notices spotting, we perform sonography to measure the thickness of the uterus. If the thickness exceeds 4 mm, the likelihood of uterine cancer increases. In such cases, we conduct further evaluation, including a pipelle biopsy or Dilation and Curettage (D&C) to obtain a sample of the inner lining of the uterus. We then test these samples to determine whether the person has cancer.
What are the treatment options for uterine cancer based on its type and stage?
Dr Viral Patel: The type and stage of uterine cancer are crucial factors in determining the treatment option. In later stages, surgery is generally not recommended unless we are confident it will benefit the patient. Currently, there are three types of surgical intervention methods available for uterine cancer. The first is the traditional open method, where we cut open the abdomen and perform the surgery. The second method is laparoscopy, and the third is an advanced laparoscopic method. After the surgery, we send whatever we remove to pathology. Based on the report we receive, we then determine whether the patient requires chemotherapy or radiation therapy.
Are there any side effects or complications of the treatment for uterine cancer? And how can one manage them?
Dr Viral Patel: Complications are associated with any type of surgery. Side effects may occur due to anaesthesia, and specifically in surgeries for uterine cancer, there can be injuries to the organs surrounding the uterus. However, the risks and complications significantly reduce if the procedure is performed by an experienced doctor. Similarly, chemotherapy and radiation therapy also come with associated complications.
Are there any known preventive measures or lifestyle changes that can help women reduce the risk of developing uterine cancer?
Dr Viral Patel: Yes, prevention is better than cure. Lifestyle changes can mitigate the risk of uterine cancer, particularly in cases where factors like obesity play a role. Incorporating more leafy vegetables and fibres into your diet helps maintain hormonal balance. In instances of genetic risks, screening is crucial. If there is a family history of uterine cancer, early diagnosis through screening becomes essential. Additionally, avoiding smoking and alcohol is important in reducing the risk of uterine cancer. Delayed pregnancies or lack of pregnancy can also increase the risk of uterine cancer.
How can patients diagnosed with uterine cancer be effectively rehabilitated?
Dr Viral Patel: This is a crucial factor, and I prioritize the emotional and psychological well-being of all my patients. The mere mention of cancer can be frightening for people, and the treatment process is both tedious and lengthy. We need to provide support at every stage, and I always advise the family and relatives to assist and support patients throughout their journey. While women usually receive support up to the surgery, ideally, this support should continue even after the treatment procedures. Family support is essential for emotional and psychological well-being. In every consultation, doctors can provide motivation. Psychologically and sexually, some patients express concerns about the impact on their sexual activity after surgery and chemotherapy or reduction treatment. In such cases, we suggest the use of vaginal dilators and appropriate products to help them resume their sexual activity as before the surgery or cancer treatment.
What are some effective health literacy strategies to educate women on uterine cancer risk factors and early warning signs, aiming to promote early detection and intervention?
Dr Viral Patel: I openly discuss various signs and symptoms of uterine cancer. To raise awareness, we’ve initiated social media campaigns covering different aspects, including risk factors and ways to identify signs. I advise my patients not to dismiss signs and to openly communicate any symptoms they experience. Although many people now engage in open discussions about these matters, some segments of society still consider it taboo. Hence, we strive to encourage openness and urge individuals to share everything with us. I believe that media coverage and social media campaigns can empower and educate women, aiding in the early detection of uterine cancer.
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